Tong Liao Shi

Researchers are evaluating the effectiveness of drug-eluting stents combined with aggressive medical treatment compared to standard medical treatment alone in preventing stroke recurrence within one year for patients with symptomatic intracranial atherosclerotic disease. This prospective, multi-center, randomized trial focuses on patients who have experienced ischemic stroke related to severe narrowing of major intracranial arteries. The study aims to assess stroke and death rates within 30 days of enrollment or revascularization procedures, as well as ischemic strokes occurring up to one year after enrollment. Participants are randomly assigned to receive either a drug-eluting sirolimus stent implanted using a balloon-expandable system along with aggressive medical treatment or standard medical treatment alone. Aggressive treatment includes dual antiplatelet therapy with aspirin plus clopidogrel or ticagrelor for six months, while standard treatment involves similar medications for three months. Both groups receive risk factor management addressing hypertension, diabetes, lipid metabolism, smoking, and exercise. The stent system features a rapid exchange catheter with a semi-compliant balloon for intracranial artery treatment. During the study, participants undergo regular monitoring to track any strokes, death, or bleeding complications over 12 months. Key assessments include clinical evaluations and safety monitoring for bleeding severity using the GUSTO score. The trial measures the occurrence of stroke or death within the first 30 days after enrollment or revascularization and ischemic strokes in the treated artery territory from 31 days to one year. The total follow-up period lasts 12 months to evaluate the long-term outcomes of these treatments.

Stroke is the second leading cause of death worldwide, with ischemic stroke being the most common type. The current best treatment for acute ischemic stroke is intravenous thrombolysis using recombinant tissue plasminogen activator (rt-PA) given within 4.5 hours of symptom onset. However, some patients experience stroke progression or early blood vessel reocclusion after thrombolysis, which worsens neurological function and outcomes. This is believed to be caused by increased platelet activation after thrombolysis, which peaks within the first 2 hours. This clinical trial is testing whether starting oral aspirin early after intravenous thrombolysis can improve functional outcomes without causing more bleeding problems. Patients are randomly assigned to receive either 300 mg aspirin tablets or matching placebo tablets as soon as possible after enrollment. If swallowing is difficult, tablets can be crushed and given through a nasogastric tube. Both groups receive best medical management according to guidelines. The study is a Phase 3, multicenter, randomized, placebo-controlled trial. Participants will be followed for 90 days after stroke to measure their functional recovery using the modified Rankin scale (mRS). Researchers will check if patients have a good outcome defined as an mRS score of 0 or 1 at 90 days. During the study, patients undergo assessments including neurological exams and imaging to confirm eligibility and monitor safety. The trial aims to determine if early aspirin treatment after thrombolysis is safe and can help prevent neurological decline and improve recovery.

Chronic obstructive pulmonary disease (COPD) is a common long-term lung condition often accompanied by other health issues. These overlapping conditions can cause symptoms to change, lead to sudden worsening of COPD, hospital stays, and ongoing disease progression. The IMPACT COPD Cohort (China) is a large, multi-center observational study designed to gather real-world data on managing COPD along with its related health problems using both Chinese and Western medical approaches. Participants will continue receiving usual medical care based on established GOLD guidelines and local practices. The study collects ongoing data through standard clinical tests including symptom questionnaires, lung function tests, imaging, and biomarker analysis. Additionally, participants will use continuous multisensor digital devices that monitor heart rate, blood pressure, physical activity, sleep patterns, and other physiological and behavioral signs. Digital Traditional Chinese Medicine assessments such as tongue, pulse, and facial diagnostics will also be performed. No specific treatments are assigned by the study. Throughout the study, researchers will gather and analyze data on participants’ health status, lung function, and comorbidity development over up to 36 months. They will monitor the yearly rate of COPD flare-ups and track related conditions like hypertension, heart disease, and diabetes. The study aims to identify risk factors, develop prediction tools for acute episodes and comorbidities, and support long-term management strategies including early detection and risk warnings across hospital, community, and home settings.

This research investigates how weight loss through a diet management mobile app and an intelligent weight scale affects cardiovascular health in obese patients with heart failure. The study focuses on patients with heart failure with reduced ejection fraction and aims to see if these tools can reduce death rates, hospital stays related to heart failure, and improve frailty and quality of life. The trial addresses a gap where current heart failure guidelines recognize obesity as a risk but lack effective interventions for this group. Participants are randomly assigned to one of two groups: one group uses a fully functional diet management app and intelligent weight scale designed to support weight loss in obese heart failure patients, while the other group uses limited-function versions of the app and scale as a comparison. Both groups use the app at every meal and the scale daily for 12 months. The trial is a multicenter, single-blind randomized controlled study. During the study, participants will visit the clinic after 12 months for checkups. Researchers will collect data on a composite cardiovascular outcome, including all-cause mortality and hospitalizations related to heart failure, tracked over one year. Adherence to app and scale use is monitored through the mobile application. The study measures the impact on heart failure frailty, quality of life, and overall cardiovascular outcomes over the trial period.

Researchers are evaluating the safety and effectiveness of selective intra-arterial cooling infusion combined with endovascular therapy in treating acute ischemic stroke caused by large vessel blockage in the brain's anterior circulation. This randomized, controlled, subject- and assessor-blinded trial plans to enroll 258 adults aged 18 to 80. The study aims to improve outcomes beyond what current endovascular therapy alone achieves, as only about 46% of patients regain functional independence after treatment. The trial builds on prior findings that targeted cooling of the affected brain area may protect tissue without causing harmful drops in overall body temperature. Participants will be divided into two groups. One group receives best medical management plus endovascular therapy, while the other undergoes selective intra-arterial infusion of cold saline through a micro-catheter before and after reopening the blocked vessel, in addition to the same medical management and endovascular therapy. The cold saline is infused at controlled rates and intervals to cool the ischemic brain region safely. This procedure occurs during the thrombectomy intervention and includes repeated infusions post-recanalization. Throughout the study, participants will have face-to-face assessments at the time of randomization, 24 and 48 hours later, and at 7 days or discharge. Follow-up interviews will be conducted by phone or in person at 30 and 90 days after randomization. Researchers will monitor safety and measure recovery using the Modified Rankin Scale at 90 days to evaluate disability levels. This comprehensive schedule ensures careful observation of participants' neurological status and treatment effects over time.

Researchers are evaluating the safety and effectiveness of intravenous urokinase compared to intravenous alteplase in treating acute ischemic stroke (AIS) within 6 hours of symptom onset. Alteplase is currently the recommended treatment within 4.5 hours but is costly, while urokinase is more affordable. Existing evidence about urokinase's effectiveness and safety is mixed, with some studies suggesting it may improve blood flow and reduce bleeding risks compared to alteplase, while others indicate it may be less effective. This study aims to provide real-world data on these treatments across multiple centers in China. The study involves two treatment groups receiving either intravenous urokinase or intravenous alteplase. Both drugs are administered through the veins. The study will explore different dosing levels of urokinase and analyze associated risk factors. Alteplase serves as the active control to compare outcomes and economic effects. This nationwide, prospective study will observe and analyze patients receiving these treatments to assess their impact on AIS. Participants will be assessed through imaging to confirm stroke type and exclude hemorrhage. Researchers will monitor functional outcomes using the modified Rankin Scale at 90 days post-treatment, tracking good recovery levels. Data on safety, adverse reactions, and mortality will be collected, along with economic evaluations. Participants must be followed for at least 90 days to evaluate long-term outcomes and treatment safety.